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Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia. 2007

Arlene F Tolentino-DelosReyes, and Susan D Ruppert, and Shyang-Yun Pamela K Shiao
The School of Nursing, The University of Texas Health Science Center at Houston, TX 77030, USA.

OBJECTIVE To examine critical care nurses' knowledge about the use of the ventilator bundle to prevent ventilator-associated pneumonia. METHODS Published reports were reviewed for current evidence on the use of the ventilator bundle to prevent ventilator-associated pneumonia, and education sessions were held to present the findings to 61 nurses in coronary care and surgical intensive care units. Changes in the nurses' knowledge were evaluated by using a 10-item test, given both before and after the sessions. Changes in the nurses' practices related to ventilator-associated pneumonia, including elevation of the head of the bed to 30 degrees to 45 degrees , were observed in 99 intubated patients. RESULTS After the education sessions, the nurses performed better on 8 of the 10 items tested (P from .03 to <.001). The areas of most significant improvement were elevation of the head of the bed (P < .001), charting of the elevation of the head of the bed (P= .009), oral care (P= .009), checking of the nasogastric tube for residual volume (P = .008), washing of hands before contact with patients (P < .001), and limiting the wearing of rings (P < .001) and nail polish (P = .04). Even after the education sessions, the nurses' compliance with hand-washing recommendations before contact with patients was low, though statistically some improvement was apparent. Contraindications to elevation of the head of the bed did not appear to affect the nurses' practices (P= .38). CONCLUSIONS Education sessions designed to inform nurses about the ventilator bundle and its use to prevent ventilator-associated pneumonia have a significant effect on participants' knowledge and subsequent clinical practice.

UI MeSH Term Description Entries
D007318 Inservice Training On the job training programs for personnel carried out within an institution or agency. It includes orientation programs. Employee Orientation Programs,Orientation Programs, Employee,On-the-Job Training,Training, Inservice,Employee Orientation Program,On the Job Training,Orientation Program, Employee,Program, Employee Orientation,Programs, Employee Orientation,Training, On-the-Job
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009731 Nursing Audit A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of nursing care. Audit, Nursing,Audits, Nursing,Nursing Audits
D012121 Respiration, Artificial Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2). Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012122 Ventilators, Mechanical Mechanical devices used to produce or assist pulmonary ventilation. Mechanical Ventilator,Mechanical Ventilators,Respirators,Ventilators, Pulmonary,Pulmonary Ventilator,Pulmonary Ventilators,Ventilator, Pulmonary,Ventilators,Respirator,Ventilator,Ventilator, Mechanical
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D004509 Education, Nursing, Continuing Educational programs designed to inform nurses of recent advances in their fields. Education, Nursing, Post-Basic,Education, Nursing, Post-Registration,Nursing Education, Continuing,Nursing Education, Post-Basic,Nursing Education, Post-Registration,Post-Basic Nursing Education,Post-Registration Nursing Education,Continuing Nursing Education,Education, Continuing Nursing,Education, Post-Basic Nursing,Education, Post-Registration Nursing,Nursing Education, Post Basic,Nursing Education, Post Registration,Post Basic Nursing Education,Post Registration Nursing Education

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